This invention relates to a method for removing an internal organ of a patient. More particularly, this invention is directed to a method for removing such an organ which is coupled to adjacent tissues or organs via connective tissue The invention is particularly suitably for removing a gall bladder but may additionally be used for removing other organs or portions of organs. This invention also relates to an instrument assembly utilizable in the method.
A commonly performed surgical operation is the removal of gall bladders. When a bladder fills with stones, it must be removed.
Conventionally, gall bladders are removed through abdominal surgery. A long incision is made in the abdominal wall and the surgeon operates on the open abdominal organs. This procedure requires a substantial quantity of blood for transfusion to the patient. In addition, hospitalization time is long and recuperation is painful.
Other organs internal to a patient such as an ovary, a uterus, a bowel section or an appendix are conventionally removed through open abdominal surgery. The disadvantages of open abdominal surgery are common to all such procedures.
A new kind of surgery used in the removal of gall bladders is laparoscopic surgery.
Laparoscopy involves the piercing of a patient's abdominal wall and the insertion of a cannula through the perforation. Generally, the cannula is a trocar sleeve which surrounds a trocar during an abdomen piercing operation. Upon the formation of the abdominal perforation, the trocar is withdrawn while the sleeve remains traversing the abdominal wall. A laparoscopic instrument, such as a laparoscope or a forceps, is inserted through the cannula so that a distal end of the instrument projects into the abdominal cavity. The laparoscope is a fiber optic instrument which enables visualization of internal organs, for example, on a video monitor connected to the laparoscope.
Generally, in a laparoscopic surgical procedure, three or four perforations are formed in the abdomen to enable deployment of a sufficient number of laparoscopic instruments to perform the particular surgery being undertaken. Each perforation is formed by a trocar which is surrounded by a sleeve, the sleeves or cannulas all remaining in the abdominal wall during the surgical procedure.
Prior to insertion of the first trocar and its sleeve, a hollow needle is inserted through the abdominal wall to enable pressurization of the abdominal cavity with carbon dioxide. This insufflation procedure distends the abdominal wall, thereby producing a safety space above the patient's abdominal organs.
Laparoscopic surgery provides several advantages over conventional incision-based surgery. The laparoscopic perforations, in being substantially smaller than the incisions made during conventional operations, are less traumatic to the patient and provide for an accelerated recovery and convalescence. Hospital stays are minimized. Concomitantly, laparoscopic surgery is less time consuming and less expensive than conventional surgery for correcting the same problems.
In removing a gall bladder through laparoscopic surgery, one instrument is generally a forceps. The forceps is manipulated from outside the patient to grasp the gall bladder and to pull it away from the liver during a severing of connective tissue by another laparoscopic instrument which is inserted into the abdominal cavity through another trocar sleeve.
Sometimes the gall bladder is thin and perforates upon being grasped by the forceps. In that case, bile in the bladder spills out into the abdomen. In addition, one or more gall stones are occasionally lost. Such an eventuality is not conducive to patient care and warrants a time consuming search for the lost stone or stones.